1. METAN Presents
ENVIRONMENTAL FRIENDLY AND ECONOMICAL
HEALTHCARE WASTE MANAGEMENT PROJECT
Presented y By Dr. CEMAL KALDIRIMCI ( www.metan.com.tr )

2. We would be pleased to be your partner to
implement state of the art medical waste
management and treatment solutions in your
region

3. What
Healthcare Waste Management
Aims at
To protect the PUBLIC and the
ENVIRONMENT from exposure to
DISEASE CAUSING AGENTS or
HARM CAUSED by
HAZARDOUS HEALTHCARE WASTES

4. Implementing waste
management
Why hospital waste management?
•Protection of the human health by reducing the exposure
of patients and the public to harmful goods
•Enhanced community relations by demonstrating a
commitment to environmental protection (positive press
coverage)
•Avoidance of long term liability (Responsibility of the
generator)
•High efficient, low cost waste logistic and disposal
•Increased employee morale, resulting from a healthier and
safer work environment
•Longterm savings of disposal costs

5. STEPS OF IMPLEMENTING
STATE OF THE ART
HEALTHCARE WASTE MANAGEMENT
SYSTEM IN HOSPITALS FROM CONSTRUCTION
OF THE HOSPITALS TO FINAL DISPOSAL and
RECYCLING OF THE WASTE
1- MEASURES TAKEN DURING CONSTRUCTION
2- IMPLEMENT OF A PROPER IN-HOUSE
HELTHCARE WASTE MANAGEMENT
PRACTICING
3- EXTERNAL LOGISTICS
4- FINAL DISPOSAL

6. SOURCES OF MEDICAL WASTE :
The primary sources of Bio-Medical Waste are
• Hospitals
• Diagnostic Centers
• Laboratories
• Blood Banks
• Nursing Homes
• Clinics
• Veterinary Hospitals % clinics
• Pharmacy shops
• Dialysis center

7. 1- MEASURES TO BE TAKEN
DURING CONSTRUCTION OF
HOSPITAL
• Provisions for onsite segregation and
storage of all recyclables as glasses,
pallets, plasterboard, plastic, cardboard, textiles, etc.
• Provisions for internal logistics , storage and interim
storage of hazardous waste streams
• Provisions for hard-core, agricultural waste (green
waste) and general kitchen-like waste ( for instance
composting facilities )
• Provisions for establishing proper infection control
• Provisions for reducing waste generating materials
• Provisions for reducing the environmental impact to
environment

8. IMPLEMENT OF A PROPER
IN-HOUSE
HEALTHCARE-WASTE
MANAGEMENT PRACTICING

9. How Hospital Waste Generated from Medical
Operations is Segregated
Healthcare Waste
(100 %)
Non-Risk Waste
( 80 %)
Risk Waste
( 20 %)
Medical Waste
( 14,5 %)
• Infectious w.
• Pathological w.
•Sharps & Needles
Chemical Waste
( 5 %)
Recycling
( 40 %)
Other Waste
( 0,5 %)
Refuse
( 40 %)
• Photo-Chemicals
• Pharmaceuticals
•Other Chemical w.
• Radioactive w.
• Cytotoxic ,
mycotoxic,w.

10. Non-hazardous Medical Waste
Most of it (75-90%) is similar to
domestic waste. This fraction
referred to as healthcare general
waste (HCGW) is made of
paper, plastic packaging, food
preparation, etc. that haven't
been in contact with patients

11. Infectious Medical Waste can be in form of bacterial,
fungal, viral and parasitic organisms and cultured
cells and is medical waste which is capable of
producing an infectious disease.
Infectious Medical Waste
Medical waste shall be considered capable of
producing an infectious disease if
(1) it has been, or is likely to have been,
contaminated by an organism likely to be
pathogenic to healthy humans,
(2) if such organism is not routinely and freely
available in the community, AND
(3) such organism has a significant probability of
being present in sufficient quantities and with
sufficient virulence to transmit disease

12. Discarded biologic product, such as blood
or tissues, removed from operating rooms,
morgues, laboratories, or other medical
facilities. The term may also be applied to
bedding, bandages, syringes, and similar
materials that have been used in treating
patients, and body parts used in research
Simply, any waste–regardless of whether it
is potentially infectious–generated as a
result of Patient (man/animal) diagnosis
and treatment.
More simple, anything (can’t be
disinfected) that comes in contact with the
blood or body fluid .
Definition of Hazardous Medical waste

13. Examples of hazardous wastes from non-medical operations
• Used oil, hydraulic fluid, diesel fuel, or jet fuel;
• Soil contaminated with toxic or hazardous polluhydraulic fluid, diesel
fuel, or jet fuel);
• resins, roofing cement, adhesives, machinery lubricants, and caulk; •
Cleanup materials (such as rags) contaminated with the items listed
above;
• Drums and containers that once contained the items listed above;
• Computer monitors and televisions with cathode ray tubes; • Gypsum
drywall (due to sulfate); • rescent bulbs, broken mercury switches,
batteries, or thermostats); and
• Other items that may have inseparable hazardous constituents. tants
(e.g., soil contaminated with used oil, Waste paints, varnish, solvents,
sealers, thinners, Waste carpeting (due to formaldehyde contents);
Lead-based paint, lead flashing, or lead solder;
• Mercury-containing demolition wastes (e.g., fluorescent bulbs, broken
mercury switches, batteries, or thermostats);
• Other items that may have inseparable hazardous constituents.

14. BASIC SYMBOLS

16. MAIN STEPS OF IN-HOUSE MEDICAL WASTE
MANAGEMENT
The management of waste must be consistent from the point of generation
(«cradle») to the point of final disposal («grave»).
The path between these two points can be segmented schematically into eight
steps.
1. Waste minimization
2. HCW generation
3. Segregation and containerization
4. Intermediate storage (in the HCF)
5. Internal transport (in the HCF)
6. Centralized storage (in the HCF)
7. External transport
8. Treatment and final disposal

18. • Segregation
At the hospital the staff to separate
hazardous waste from domestic waste by
company providing different bag colors.
• Packaging and handling
Proper packing of waste according to it’s
nature (liquid, tissue, sharp object, etc..)
By providing different waste containers
(bags, boxes , etc , …)

19. Interim storage of infectious waste
Safe storage & transportation of hospital waste
To avoid risks for the public by spillages, etc. infectious waste must
be transported under consideration of the potential dangers by the
waste. For this, a transport in special containers is necessary.
Example:
Use of 770 l UN proved containers
Proved for the UN waste class 6.2 –
Bio hazardous waste of class I, II and III
(Low to medium infectious waste =
Typical hospital waste)

20. External Transportation:
 Periodically or on request, the
governmental licensed disposal
company comes and takes the
waste to the biomedical cell.
 The hazardous waste must be
transported according to the
applicable laws.
 The carrier must endorse the
receive of the quantity and quality
of the waste and will be responsible
for the waste after signing.
Transport of hazardous waste

21. External Transportation:
 Periodically or on request, the
governmental licensed disposal
company comes and takes the
waste to the biomedical cell.
 The hazardous waste must be
transported according to the
applicable laws.
 The carrier must endorse the
receive of the quantity and quality
of the waste and will be responsible
for the waste after signing.
Transport of hazardous waste

22. How to dispose
Healthcare Waste ,
Depending on the different waste
streams

23. Treatment and Disposal of the hospital waste
Today, international available main treatment
methods for infectious, hospital waste:
Relatively old & conventional methods:
•Land filling
•Incineration
Alternative and More Environmental Friendly &
Economic Methods:
•Chemical disinfection
•Steam disinfection/sterilization

24. Landfilling of healthcare waste
Recommended Operation:
• Special cassette for biomedical waste secured by fence and guard
• Unloading of the waste from the transportation container direct
in the shovel of the wheel loader
• Bedding of the waste in the special cassette by the wheel loader
• Covering of the infectious waste every evening with a 0,15 m –
0,20 m thick soil layer
• If necessary, first covering with gypsum
• After one layer is filled, stabilization of the layer with 0,5 m of
construction waste

25. Way of working: Incineration
By incineration, hospital waste and the
pathogen agents are oxidized. State of
the art incinerators are two chamber
systems equipped with a two stage flue
gas treatment and a CEM-System.
While in the first chamber the waste is
pyrolsed at a temperature of 300 – 500°C,
in the second chamber the pyrolysis gas
is treated at a temperature of 800 –
1200°C.
The Existing Europeam Incinerating
Directives Require the Implementation
of Very Strict Emission Control and
Monitoring ( Directive 2000/76/EC )
Healthcare waste incinerator, Hoval,

27. Incinerating mostly preferred
for
Hazardous healthcare waste!!!

28. Alternative Methods
for
Medical Waste Disposal
STERILIZATION

29. LET US DEFINE FIRST
DISINFECTION & STERILIZATION

30. WHAT IS OUR TASK THEN ?
DISINFECTING SYSTEM OR
STERILIZATION SYSTEM
OF COURSE STERILIZATION
IF WE ARE
ENVIRONMENTALLY
CONCERNED
so we have to be carefull in selecting
the appropriate system

31. WHICH ONE TO CHOOSE
ON-SITE
or
OFF-SITE
TREATMENT
METAN

32. Reasons for preferring
OFF-SITE STERILIZATION
Central Treatment Plants
METAN
• More economic total investment cost (compared to the
opposite solution of on-site installations at each hospital
) for the entire region where the plant is serving
• More economic operating costs compared to the
opposite solution of on-site installations at each hospital
)
• So, cheaper solution in cost-concerned countries
• Easier to control by governmental or private authorities
• Possibility of Recovery of Recylable material from
central treatment plants
• Business oppurtunity for operating private companies
or municipalities

33. • Cheaper solution for mainly large sıze of hospıtals
and generators
• Possibly more and better controllable for highly
environmentally concerned generators
• Avoiding from the commercial hints of the central
treatment plant owners and operators
• Smaller interim waste storage and transport cots
and staff
• Less hazardous waste transport risks on the
highways and roads
Reasons for preferring
ON SITE STERILIZATION
EQUIPMENT

34. Medical Waste Sterilizers in Two main
Categories from our solution partners
• Post-shredding kind of medical waste
sterilizers ( Conventional autoclave
type )
• Pre-shredding kind of medical waste
sterilizers , Vertical
METAN

35. METAN
STANDARD Medical Waste Sterilization
MODELS
• POST-SHREDDING KIND
• 10—125 kg/h
• 200-250 kg/h
• 500-600 kg/h
• PRE-SHREDDING KIND
• 20-50-100 - 125 kg/h
• 200 - 250 kg/h
• 400 - 450 kg/h

36. Typical vertical pre-shredder kind of
sterilizer, for on-site and off-site
installations

37. PROCESS FLOW
IN
PRE-
TREATMENT
KIND OF
STERILIZERS

38. Main criteria in selecting the equipment
• Proven technology
• Guaranteed method
• Secure sterilization
• Lower Investment Cost
• Lower Operating Cost
• Long service life
• Minimum maintenance
• 6 Log 10 or higher
inactivation

39. LARGE CAPACITY ON-SITE & OFF-SITE EQUIPMENT

40. NEW SERIES OF STERILIZERS – COMPACT
• Plug & Play
• Just power and drain connection
• No water connection
• Integrated steam generator
• Integrated 2-shaft shredder
• Very long shredder blades life time
• Mobile on castors
• Minimum 6-8 Log 10 level of efficacy

42. Typical post-shredder kind of medical
waste sterilizer

43. Standard Post-Shredder Type of Models

45. FINALLY
ENTIRELY NEW CONCEPT HAS
BECOME A TRUTH
RECYCLING OF STERILE MEDICAL
WASTE
PYROLYSIS TO PRODUCE
OIL AND CARBON BLACK

46. METAN

47. Flow Chart of Pyrolysis Plant

48. PROJECT PROPOSAL
•TRAINING
•PRACTICING HCWM
•STORAGE
•INTERNAL & EXTERNAL LOGISTICS
•STERILIZATION for infectious waste,
preferably off-site for Iraq (or on-site )
•INCINERATION for hazardous waste
•PYROLYSIS for sterile waste

49. MAIN STAGES OF THE PROJECT
DEVELOPMENT OF
IN-HOUSE HCWM PRACTICING
I . HCWM TRAINING : BASIC
II. FURNISHING THE HOSPITALS WITH PROPER WASTE
MANAGEMENT EQUIPMENT, INSTRUMENTS AND REAGENTS
III. PREPARING THE INTERNAL WASTE MANAGEMENT
GUIDELINES AND DIRECTIVES
IV. ASSIGNING AND DELEGATING THE RESPONSIBLE STAFF
IV. PRACTICING THE PROPER WASTE MANAGEMENT
GUIDELINES
V. DESIGNING AND INSTALLING THE INTERIM WASTE STORAGE
ROOMS
VI: DESIGNING AND INSTALLING IN-HOUSE WASTE STORAGE
ROOMS AND PREAPRING FOR EXTERNAL LOGISTICS

50. BASIC TRAINING, 5 DAYS
A ) HAZARDOUS WASTE
THE FOLLOWING STEPS WILL BE IMPLEMENTED
1. AWARENESS AND UNDERSTANDING THE CURRENT SITUATION
2. WASTE MINIMIZATION
3. WASTE SORTING
NON-HAZARDOUS
RECYCLABLES
HAZARDOUS
BIO-MEDICAL ( INFECTIOUS, SHARP AND
NEEDLES )
PATHOLOGIC
CHEMICAL
RADIOACTIVE
4. CONTAINERIZATION
5. LABELING
5. INTERIM STORAGE AND IN-HOUSE TRANSPORT FOR
DIFFERENT WASTE STREAMS

51. B ) HOSPITAL HYGIENE AND SANITATION
ENVIRONMENTAL SAFETY AND CLEANING
DISINFECTION
OHSA AND PERSONAL SAFETY MEASURES
C ) WASTE WATER MANAGEMENT
WATER SANITATION
MEASURES FOR WASTE WATER SAFETY AND PURIFICATION

52. SETTING UP
EXTERNAL LOGISTICS
In case of Off-Site Central
Treatment Method is
preferered

53. A ) FOR BIO-MEDICAL WASTE
With specially designed compartment, refrigerated and with safety
measures
Lift for container placement
Poprtable scale for waste weighing
Radiation detector for radioactivity check

54. B ) FOR CHEMICAL NATURE
HAZARDOUS WASTE
With specially designed compartment, refrigerated and with safety
measures
Lift for container placement
Poprtable scale for waste weighing
Radiation detector for radioactivity check

55. STERILIZATION PLANT
FOR
BIO-MEDICAL WASTE

56. BASIC MODALITIES IN THE STERILIZATION PLANT
•MEDICAL WASTE STERILIZER, 1000-1500 kg/h CAPACITY MEDICAL WASTE
STERILIZER
•STEAM GENERATOR
•WATER SOFTENING UNIT
•PLATFORM SCALE
•TILTER FOR WASTE FEEDING TO THE STERILIZER
•SHREDDER FOR STERILE MEDICAL WASTE
•LIFT FOR STERILE WASTE FEEDING TO SHREDDER
•CONTAINER WASH UNIT, AUTOMATIC
•TRUCK WASHING, CLEANING, DISENFECTING FACILITY
•TROLLEYS AND CONTAINERS
•LABORATORY
•HOUSING FOR THE ABOVE UNITS AND MODALITIES
•REFRIGERATED WASTE STORAGE ROOM
•CLEAN CONTAINER STORAGE AREA
•HYGIENIC, TECHNICAL , SOCIAL ROOMS AND OFFICES
•SAFETY MEASURES FOR FIRE, ENVIRONMENTAL SAFETY, PERSONAL
SAFETY AND HYGIENE
•POWER DISTRIBUTION SYSTEM
•EMERGENCY POWER SUPPLIES ( SOLAR OR/AND GENERATOR )
•STERILE WASTE STORAGE AREA
•DISCHARGED WATER STORAGE AND SETTLING AREA
•MISCELLANEOUS

58. General lay-out and logistics -
HWC
1 Refrigerated storage 2 Energy/W ater Supply, 3 Delivery Zone 4 Scale/Scanning Zone 5 Social rooms
6 Entrance Zone 7 Office, Adminis. 8 Container W ashing Plant 9 Interim Storage 10 Pick Up Zone
11 Hollow Container 12 Store/Treatment Photo chemicals 13 Autoclave
Car ParkGuard
1
2
3
4
8
9
10
11
6
5
12
7 7 7
13
3
1
2
3
4
8
9
10
11
6
5
12
7 7 7
133
1 Refrigerated storage 2 Energy/W ater Supply, 3 Delivery Zone 4 Scale/Scanning Zone 5 Social rooms
6 Entrance Zone 7 Office, Adminis. 8 Container W ashing Plant 9 Interim Storage 10 Pick Up Zone
11 Hollow Container 12 Store/Treatment Photo chemicals 13 Autoclave
Car ParkGuard
1
2
3
4
8
9
10
11
6
5
12
7 7 7
13
3
1
2
3
4
8
9
10
11
6
5
12
7 7 7
133
Car ParkGuard
1
2
3
4
8
9
10
11
6
5
12
7 7 7
13
3
1
2
3
4
8
9
10
11
6
5
12
7 7 7
133

59. Lay-out of the Building
1 2
3
4
8
9
10
11
6
1 Refrigerated storage 2 Energy/Water Supply, 3 Delivery Zone 4 Scale/Scanning Zone 5 Social rooms
6 Entrance Zone 7 Office, Adminis. 8 Container Washing Plant 9 Interim Storage 10 Pick Up Zone
11 Hollow Container 12 Store/Treatment Photo chemicals
5
12
7 7
7
13
13 Autoclave
3
1 2
3
4
8
9
10
11
6
1 Refrigerated storage 2 Energy/Water Supply, 3 Delivery Zone 4 Scale/Scanning Zone 5 Social rooms
6 Entrance Zone 7 Office, Adminis. 8 Container Washing Plant 9 Interim Storage 10 Pick Up Zone
11 Hollow Container 12 Store/Treatment Photo chemicals
5
12
7 7
7
13
13 Autoclave
3

60. Post-shredding kind
METAN

62. HAZARDOUS WASTE
DISPOSAL
STATE OF THE ART
ENVIRONMENTAL FRIENDLY
INCINERATOR
from one of our solution partners

64. INCINERATOR FOR HAZARDOUS WASTE, off-site
500 kg / h capacity
A ) INCINERATOR
1.01. Automatic Loading Unit
1.02. Primary Combustion System @1000 C -
Rotary Kiln
1.03. Secondary Combustion Chamber @1100C for
2sec
1.04. Ash Removal Conveyor
1.05 Main Stack
1.06. Control Panel
B ) EMISSION CONTROL SYSTEM, Flue Gas Treatment System
2.01. Heat Exchanger
2.02. Dry Scrubber - Activated Carbon Dosage
System
2.03. Dry Scrubber - Chemical Dosage Unit
2.04. Dry Scrubber - Bag Filter
2.05. Wet Scrubber2.06. ID Fan

65. • INCINERATOR
As one of the systems above ( The above prices are net buying prices )
• HOUSING:
Industrial plant specifications, may be steel construction, laminated sandwich panel
side walls and roof,
25 x 30 x 10 m (width x length x height) indoor
10 x 30 m + 20 x 20 m ( w x l ) outdoor
Indoor: Incinerator, operation control room, office, hygiene rooms, laboratory, technical
room
Outdoor: fuel tank, waste un-loading area, truck wash area, truck parking area, ask
storage area,
Waste storage containers room, hazardous waste storage rooms, Scale for waste
weighing
To be detailed alter upon acceptance of the incinerator offer
Requires architectural works and relevant expenses
• Laboratory and technical room:
A chemical analysis laboratory with the below equipment (minimum) is required to be
set up and operated:
• Flash point determination device
• Automatic bomb calorimeter
• Muffle furnace
• Laboratory oven
• Balance
• Moisture balance
• Basic laboratory apparatus and glassware
BASIC MODALITIES IN THE
INSINERATING PLANT

66. • Waste transport trucks :
Qty. 2-3-4
With hazardous waste transport compartments, air conditioned, lift and scale
• Waste storage containers & ash storage containers.
Galvanized steel waste bins
Qty. 200 -500 of 0.4 m3 capacity
• Fire fighting, first aid, hygiene equipment and reagents for the plant safety:
(depends on the local directives, regulations and laws)
• Truck wash and container wash unit:
Varies from manual to automatic:

68. CAPEGATE

70. What Metan Co. Ltd. may offer you:
• Consultancy in entire healthcare waste
management chain, from in-house medical waste
management practicing in hospitals to final
disposal
• Project preparation and implementation
• Waste logistics training
• Plant operation training
• Green Hospital projects preperation and
implementation
METAN

72. METAN
METAN
GREEN ENVIRONMENT & HEALTH SERVICES
INDUSTRY & TRADE Co. Ltd.
• Address: Emek Mahallesi 29. Sokak No: 38
Cankaya-Ankara-TURKEY
• E-mail:cemal@ metan.com.tr
• Web:www.metan.com.tr
• Contact: Dr. Cemal Kaldirimci +90(532) 454 90 77
• Chemical Engineer, Managing Director
We are ready to help our friends to develop the
current medical waste management practicing
and implement a state of the art system